IT interoperability: what is it, whats holding it up?

“Interoperability” has been a technology buzzword for a while now. But, what does it really mean?

Simply defined, interoperability is the ability of computer systems to “talk” to one another and easily share information. It is especially critical now as more and more of our health information is recorded and stored electronically.

Hospitals have made significant investments in electronic health records, digital versions of patients’ charts. The American Hospital Association estimates that, between 2010 and 2013, hospitals spent $47 billion annually on health information technology. About two-thirds of hospitals employ at least a basic EHR, up from only 9 percent in 2008.

EHRs enable doctors and nurses at hospitals to quickly document and review the care they provide, order medications and perform many other tasks. But patients frequently obtain services from multiple providers in multiple locations, such as hospitals, physician offices, post-acute care facilities, pharmacies, retail clinics, labs and imaging facilities. These systems often cannot talk to one another, resulting in holes, or even errors, in the health record. Hospitals are working hard to share data, but do not have the technology to support it.

To provide the best, most coordinated care possible, sharing accurate data among providers across the continuum and with patients themselves is critical. It also is essential to contain the overall cost of health care.

A critical factor in engaging patients is empowering them with meaningful information, including a summary of the care received, labs, medications, images and so forth. Such information is particularly important when patients want to engage in shared decision-making with their physicians.

Patient engagement also is a requirement of federal regulations on how to use EHRs. But most patients cannot access their information electronically, according to a report prepared for the Agency for Healthcare Research and Quality. A lack of interoperability also impedes public health reporting.

The AHA recently released two reports outlining just why interoperability is so critical, as well as recommendations from a special advisory group for advancing interoperability to support care transformation. The advisory group identified multiple barriers that fall into three categories — insufficient infrastructure, technology challenges and unresolved policy issues — and actions required by both the private and public sectors, including IT vendors, to make true interoperability a reality.

Fred Gattas Jr. (fpgattas@gmail.com), is COG chair and a trustee of St. Jude Children’s Research Hospital in Memphis, Tenn.